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NPI Code Detail

MEDICARE: VK BEAUTY AESTHETIC MEDICAL PROFESSIONALS LLC

MEDICARE: VK BEAUTY AESTHETIC MEDICAL PROFESSIONALS LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QP2300XPrimary Care Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11174164651OTHERFLNPI

General Provider Information

NPI Number : 1518602036
Entity Type Code : Organization
Provider Name (Legal Business Name) : VK BEAUTY AESTHETIC MEDICAL PROFESSIONALS LLC
Provider Business Mailing Address
First Line : 50 PEN NA NA DR
Second Line :
City : HIALEAH
State : FL
Zip : 33010-5230
Country : US
Telephone Number : 786-909-7485
Fax Number :
Provider Business Practice Location Address
First Line : 1254 E 4TH AVE
Second Line :
City : HIALEAH
State : FL
Zip : 33010-3502
Country : US
Telephone Number : 306-364-5880
Fax Number : 786-629-5437
Authorized Official
Title or Position : OWNER
Name : KIRENIA SALVAT
Credential : APRN
Telephone Number : 786-909-7485
Provider Enumeration Date : 04/29/2022
Last Update Date : 04/29/2022

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